Dr Maite Ferrin is a Consultant Psychiatrist at , a brain and mind clinic with a specialist which was established to help diagnose and treat a wide range of mental health conditions affecting children and adolescents. Mental health is a big concern amongst this age group. According to Public Health England 2016, up to 10% of young people between the ages of 5 to 16 years suffer from a diagnosable mental health illness.
Dr Ferrin has vast experience in treating children and adolescents with all types of mild and more severe psychiatric conditions including depression and self-harm. She shares her insight on self-harm with advice on dealing with the issue, a growing concern amongst adolescents in the UK.
It was revealed in a recent study The Good Childhood Report by the Children’s Society that nearly a quarter of teenaged girls in the UK are self-harming. This research follows a study published by the British Medical Journal in April this year which reported a 68% increase in self-harm amongst 13-16 girls between 2011 and 2014 in the UK.
This is cause for alarm and big steps need to be taken to address the unhappiness of teenagers before this turns into a mental health crisis amongst teenagers.
Self-harm is described as, ‘Any intentional act causing physical injuries to oneself without a clear intention to die’. However, the study published in the British Medical Journal also highlighted that self-harm is the strongest risk factor for subsequent suicide, with suicide being the second most common cause of death before age 25 worldwide.
Self-harm is an adaptive coping mechanism to deal with any stressor in life which may include social media pressure, bullying, problems with sexuality, school pressure or problems within the home or social environment, to name a few. However, self-harming may also reflect a more impairing psychological condition such as anxiety, depression or PTSD.
Many different reasons have been suggested for self-harming including an attempt to alleviate emotional pain that cannot be expressed verbally, self-punishment e.g., an attempt to relieve feelings of shame or guilt, an attempt to stop feeling numb, to communicate psychological anxiety or even a cry for help or to seek attention.
Self-harming, which can also be referred to as self-injury or self-mutilation, can take shape in many different forms with the most common methods including:
- Superficial cutting with a knife or razor usually on the arms, hands or wrists but may also be hidden on thighs of the torso
- Punching or hitting oneself so marks are made
- Scratching or ripping the skin where blood is drawn and marks are left
- An intentional drug overdose
- Hair pulling – known as trichotillomania is where the individual pulls out their own hair and in some cases, may ingest it.
- Many young people who self-harm use more than one method of self-injury, and some of them do it on a regular basis, whilst others do it more sporadically.
It’s important that children feel valued and supported and that they have someone to talk to minimise self-injurious behaviour, improve happiness and eliminate risk of suicide. Self-harming habits may be habit-forming and it’s important that steps are taken to reduce.
Approach with caution
If you suspect an adolescent is engaging in deliberate self-harm, it’s advisable to approach with caution. The majority of young people who self-harm feel ashamed of their behaviour. An initial empathetic approach is recommended as they may worry about the negative judgement of others.
When approaching the subject to a self-harmer, it’s very important to listen to the person so they feel encouraged to open up and talk. This is especially important for young people with self-harm, who often feel invisible, unheard and misunderstood. A safe space should be created for them to freely discuss their problems without interruption, so that they are more inclined to open up and discuss their problems.
Use empathetic language
When speaking with individuals who self-harm, use simple empathic responses that withhold negative judgement so they can validate their emotional experiences. Phrases such as “sounds like things have been quite tough for you”, “I can see how this would be very challenging”, “I understand how difficult this must be for you” can be useful.
It’s also vital to offer the young person some hope and support e.g. ‘Thank you for sharing this with me. Let’s think about how we can make you feel better’.
Some practical tips to help parents of teenagers with self-harm tendencies:
- Remain calm – getting upset, uptight or emotional may discourage the child to close up and refrain from talking
- Validate and acknowledge their emotions and struggles. Share any relevant and relatable experiences
- If the child does not feel comfortable talking or is not ready to open up, it’s important not to force them as this could escalate problems
- Do not punish or minimise their feelings or the self-harm act – this may deepen the guilt or shame
- It’s advisable to focus on the underlying struggles of the child rather than the actual act of self-harm – remember that the self-harm is a consequence and often a coping mechanism of their troubles – address the cause and not the symptom
- Encourage healthy ways of coping with stress – whether exercising, meditation, deep breathing reading or art, help find the best coping mechanism
- Allow them time to learn alternative healthier coping mechanisms to replace the self-harm behaviours
- Reinforce the young person’s strengths – sometimes it’s all too easy to focus on the negatives rather than embracing and celebrating the positive attributes of the individual
- It can take time to change behaviour – don’t expect a quick fix for the self-injurious behaviour. It can take a long time to break a habit or change mindset.
- Accept that you cannot do it alone – seek support from school counsellors or people that have shared a similar experience. There are lots of online resources that provide great information
- When an underlying psychiatric condition is suspected (e.g. anxiety, depression, PTSD, etc), or for those who have poor responses to initial approaches earlier described, a referral to a specialist should be considered.